Analysis of influencing factors of lower respiratory tract infection in patients after neurosurgery based on propensity score matching
Objective To analyze the influencing factors of lower respiratory tract infection in patients after neurosurgery based on propensity score matching,identify the intervention factors of lower respiratory tract infection after neurosurgery,and guide the clinical staff to take preventive measures for the intervention factors in the perioperative period of patients.Methods Data of 2 199 patients undergoing neurosurgery in the Second Affiliated Hospital of Chongqing Medical University from January 2021 to December 2023 were retrospectively collected.According to the incidence of lower respiratory tract infection,they were divided into infected group(319 cases)and uninfected group(1 880 cases),the infection of lower respi-ratory tract and the distribution of bacteria detected in patients after neurosurgery were collected.Patients were matched 1:1 based on age,sex,emergency department,American Society of Anesthesiologists score,smoking history,and history of chronic obstructive pulmonary disease,the influencing factors of lower respiratory tract infection in patients after neuro-surgery were analyzed.Results Lower respiratory tract infec-tion occurred in 319(14.51％)of the 2 199 patients who un-derwent neurosurgical treatment,with 190 strains of pathogens isolated,including 44 strains(23.16％)of Gram-positive bac-teria,137 strains(72.11％)of Gram-negative bacteria,and 9 strains(4.74％)of fungi.There were statistically significant differences between two groups in operation time,operation mode,postoperative stay time in intensive care unit,ventilation mode,incision classification,preoperative and postoperative blood glucose levels(P＜0.05).Operation time,operation mode,and ventilation mode were the risk factors for lower respira-tory tract infection in patients after neurosurgery(OR=1.16,8.06,1.80,P＜0.05).Conclusion In order to reduce the inci-dence of lower respiratory tract infection in patients after neurosurgery,medical staff can give priority to minimally invasive surgery in terms of operation mode,shorten the operation time from various aspects,implement perioperative respiratory tract management measures,and realize autonomous ventilation as soon as possible.
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